Isolatable automatic drug compounding system

ABSTRACT

A low-cost drug compounding system that can practically fit inside of a fume hood or the like is provided. The system can use a single pump operable in forward and reverse directions (or multiple pumps) to compound complex mixtures particularly including those requiring the creation of solutions from dry or powdered ingredients. A wireless link allows operation of the system remotely. In one embodiment, the system uses a disposable mixing tube set that can be discarded after mixing while still attached to the base ingredient containers used for the compounding thereby minimize the chance of personnel exposure.

CROSS-REFERENCE TO RELATED APPLICATION

This application claims the benefit of U.S. Provisional Application No.62/422,700, filed Nov. 16, 2016.

BACKGROUND OF THE INVENTION

The present invention relates to systems for compounding drugs and inparticular to systems that reduce operator exposure to drug ingredientsduring such compounding.

Medical drugs must often be prepared from base ingredients close to thetime when they are administered in order to provide for maximumefficacy. For this reason, it is desirable to be able to prepare drugadmixtures in a medical care environment such as a hospital or the like.For some drugs, however, the base ingredients can present risks topersonnel who may be accidentally exposed to those ingredientsparticularly in concentrated form. This risk normally requires the useof specially trained personnel and in some cases a separate facility inwhich such admixtures can be created such as removes the mixing processfrom patients and hospital staff or the like.

SUMMARY OF THE INVENTION

The present invention provides a low-cost drug compounding system thatcan practically fit inside of a fume hood or the like. The system canuse a single pump operable in forward and reverse directions (ormultiple pumps) to compound complex mixtures particularly includingthose requiring the creation of solutions from dry or powderedingredients. A wireless link allows operation of the system remotely. Inone embodiment, the system uses a disposable mixing tube set that can bediscarded after mixing while still attached to the base ingredientcontainers used for the compounding thereby minimize the chance ofpersonnel exposure.

In one embodiment of the present invention, a drug compounding systemincludes an outer housing providing an internal cavity accessiblethrough a door which may be opened and closed about the cavity; aperistaltic pump held within the internal cavity; a first shut offvalve; a second shut off valve; a third shut off valve; and a controllerexecuting a stored program stored in memory to: communicate with theprogram, the peristaltic pump, the first shut off valve, the second shutoff valve, and the third shut off valve; and control operation of theperistaltic pump, the first shut off valve, the second shut off valve,and the third shut off valve according to the program; where the first,second, and third shut off valves and the peristaltic pump areconfigured to receive a mixing tube assembly having a central tubesection providing a compliant wall surrounding a lumen for receipt ofthe central tube section by the peristaltic pump for pumping materialthrough the central tube section by flexure of the wall of the centraltube section and a branch connector communicating with a first end ofthe central tube section to provide conduits to a first and secondflexible branch tubes joining the lumen of the central tube section tolumens of the first and second flexible branch tubes; and where thecentral tube fits within the first shut off valve configured to permitflow through the central tube in an open state and prevent flow throughthe central tube in a closed state, the first flexible branch tube fitswithin the second shut off valve configured to permit flow through thefirst flexible branch tube in an open state and prevent flow through thefirst flexible branch tube in a closed state, and the second flexiblebranch fits within the third shut off valve configured to permit flowthrough the second flexible branch tube in an open state and preventflow through the first flexible branch tube in a closed state.

It is thus a feature of at least one embodiment of the invention topermit drug compounding within a sealed environment where theingredients may be disposed of with the mixing tubing set withoutdisconnection.

The door may provide an airtight seal of the internal cavity when in theclosed state.

It is thus a feature of at least one embodiment of the invention toprevent exposure of drug ingredients, e.g., powders, to the environmentand prevent contamination within the drug compounding system.

A port in the outer housing may provide for connection to a fumeextraction system.

It is thus a feature of at least one embodiment of the invention toprevent fumes generated during drug compounding to enter theenvironment.

The outer housing may attach flexible gloves extending within theinternal cavity and allowing an operator outside the outer housing tomanipulate elements within the internal cavity.

It is thus a feature of at least one embodiment of the invention toallow the operator to open medicament containers and connect variousconnectors to those containers within a sterile environment.

The door may have a switch providing a door open condition to thecontroller to prevent operation of the peristaltic pump.

It is thus a feature of at least one embodiment of the invention toensure an airtight environment within the glovebox.

A sensor may be held within the internal cavity and sensing fluid flowthrough the central tube section to analyze a chemical composition of amaterial flowing through the central tube section to establish a drugsignature. The sensor may be a Raman spectrometer.

It is thus a feature of at least one embodiment of the invention toensure proper compounding of the drug ingredients and to monitor fluidflow volumes.

The computer may execute the stored program stored in memory to: openthe first and second shut off valves to permit fluid flow through thefirst flexible branch tube and central tube section and close the thirdshut off valve to prevent fluid flow through the second flexible branchtube; pump fluid in a forward direction from the first flexible branchtube to the central tube section; open the first and third shut offvalves to permit fluid flow through the second flexible branch tube andcentral tube section and close the second shut off valve to preventfluid flow through the first flexible branch tube; and pump fluid in areverse direction from the central tube section to the second flexiblebranch tube.

It is thus a feature of at least one embodiment of the invention toallow a mixing fluid to be compounded with a dry drug ingredient andthen refilled into a mixture receiving bag.

The system may have a sensor where the computer executes the storedprogram stored in memory to: detect a first amount of fluid pumped fromthe first flexible branch tube to the central tube section; and detect asecond amount of fluid pumped from the central tube section to thesecond flexible branch tube.

It is thus a feature of at least one embodiment of the invention to knowthe amount of fluid volume within the IV tubes after trapped air isrelease to transfer the proper fluid volumes.

A second end of the central tube may communicate with a first connectoradapted for attachment to a medicament vial, the first flexible branchtube may communicate with a second connector adapted for attachment toan IV bag, and the second flexible branch tube may communicate with athird connector adapted for attachment to a mixture receiving bag. TheIV bag may contain a mixing fluid and the medicament vial contains adissolvable drug ingredient.

It is thus a feature of at least one embodiment of the invention toallow for compounding of a dry drug ingredient with a mixing fluid.

A scale may be held within the internal cavity adapted to support themixture receiving bag to provide a weight of the mixture receiving bag.

It is thus a feature of at least one embodiment of the invention toensure the compounded medicament has the correct weight to ensure propercompounding.

A hanger may be held within the internal cavity for hanging the first IVbag positioned above the peristaltic pump.

It is thus a feature of at least one embodiment of the invention toallow intravenous drugs to be gravity fed into a medicament vial.

A mixer may be held within the internal cavity and configured to shakethe medicament vial.

It is thus a feature of at least one embodiment of the invention toprovide automatic mixing of dry ingredients with the mixing fluid.

In one embodiment of the present invention, a drug compounding tubingassembly includes a central tube section providing a compliant wallsurrounding a lumen for receipt of the central tube section by aperistaltic pump for pumping material through the central tube sectionby flexure of the wall of the central tube section; a branch connectorcommunicating with a first end of the central tube section to provideconduits to a first and second flexible branch tubes joining the lumenof the central tube section to lumens of the first and second flexiblebranch tubes; IV bag spikes attached to ends of the first and secondflexible branch tubes adapted for attachment to a first and second IVbags to communicate between volumes of the first and second IV bags andlumens of the first and second flexible branch tubes; and a medicamentcap connector communicating with a second end of the central tubesection and adapted to be releasably attached to a medicament containerto communicate between a volume of the medicament container and thelumen of the central tube section.

It is thus a feature of at least one embodiment of the invention toprovide a tubing system to be used in the drug compounding system thatis cheap and disposable.

The medicament cap connector may have a filtered vent permitting air toexit the medicament vial when the medicament cap connector is attachedto the medicament vial.

It is thus a feature of at least one embodiment of the invention toallow gas trapped within the tubing to escape during the mixing process.

The medicament cap connector may have a siphon tube extending into themedicament vial when the first connector is attached to the medicamentvial.

It is thus a feature of at least one embodiment of the invention toallow the admixture to be pumped from the medicament vial to a mixturereceiving bag.

The medicament cap connector is a spike adapted for attachment to themedicament container.

It is thus a feature of at least one embodiment of the invention toallow for removable interconnection of the tubing with the medicamentvial.

The first and second flexible branch tubes may be polyvinyl chloride(PVC) tubing. The central tube section may be silicone rubber tubing.

It is thus a feature of at least one embodiment of the invention toprovide biocompatible tubing where the central tube section is flexiblefor flexing use with peristaltic pumps.

The branch connector may be a T-connector providing fluid communicationbetween the first end of the central tube section and the first andsecond flexible branch tubes.

It is thus a feature of at least one embodiment of the invention toallow for interconnection of at least three separate medical tubing.

These particular objects and advantages may apply to only someembodiments falling within the claims and thus do not define the scopeof the invention.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1 is a perspective view of a glove box adapted for use with thepresent invention providing a closed, negative pressure environment fordrug compounding;

FIG. 2 is a simplified diagram of the compounding system that may fitwithin the glove box of FIG. 1 including a controller controlling a pumpand multiple valves;

FIG. 3 is a flowchart showing operation of the pump and valves of thecompounding system of FIG. 2 for an example compounding process; and

FIG. 4 is a figure of a disposable mixing tube set suitable for use withthe present invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

Referring now to FIG. 1, the compounding system 10 of the presentinvention may work within a glovebox 12, the latter providing agenerally box-shaped enclosure 14 sealable in an airtight manner by anopenable front door 16. Alternatively, a double door can be implementedfor added safety. The enclosure 14 may include an exhaust port 18communicating with a fan system 20 drawing air out of the enclosure 14and filtering this exhaust air for discharge safely out of the buildingand thereby creating a negative pressure in the enclosure 14 reducingthe chance of escape of materials therefrom.

Apertures 22 in a side wall of the enclosure 14 may attach to flexibleairtight gloves extending within the enclosure 14 allowing an operatoroutside of the enclosure 14 to manipulate elements inside the enclosure14 as will be discussed.

Referring now to FIG. 2, gloves 24 attached to the apertures 22 may beproximate to a drug ingredient mount 26 a holding a first vial 28 acontaining a powdered drug ingredient 30 a. The vial 28 a is generallysealed by a cap 32 a having a filtered vent 34 a permitting the passageof air out of the vial 28 a without the escape of the drug ingredient 30a and having a siphon tube 36 a attachable to a mixing tube set 38 bymeans of a connector 40 a. Alternatively, the filtered vent or siphontube can be one element integrated on the connector 40 a, instead of onthe cap of the vial. In this way standard vials may be used. Thefiltered vent 34 a may have a check valve to block fluid flow but permitgas flow out of the vial 28 a.

During operation, liquid will pass from a branch tube 39 a and itsassociated connector 40 a into the vial 28 a to mix with the drugingredients 30 a as air escapes through the filtered vent 34 a. Anoperator at particular times may use the glove 24 to remove the vial 28a from the mount 26 a to shake the vial 28 a, ensuring completedissolving of the drug ingredient 30 a. These manual processes can becompleted by a robot arm inside the box as well or alternatively.

Alternatively, or in addition, a second mount 26 b may be providedholding a second vial 28 b with a second drug ingredient 30 b and havinga second vent 34 b and siphon 36 b, the latter attached to a secondconnector 40 b leading to a second branch tube 39 b. In this case thesecond mount 26 b may include an electromagnetic actuator 42 (such as amotor and eccentric weight) that can be used to shake the vial 28 bwithout operator intervention.

Referring also to FIG. 4, connectors 40 a and 40 b, attached to separateflexible branch tubes 39 a and 39 b respectively of the mixing tube set38, are next received by a T connector 44 a where they join into asingle pliable pump tube 46 (for example, of silicone rubber orpolyvinylchloride (PVC)) that may be installed in a peristaltic pump 50or the like capable of pumping material through the pliable pump tube 46without contact with that material in the pliable pump tube 46. Thebranch tubes 39 may be of flexible materials such as silicone orpolyvinylchloride (PVC).

The opposite end of the pliable pump tube 46 may connect to a second Tconnector 44 b separating into two branch tubes 39 c and 39 d,respectively, one providing a tube leading to a connector 40 c attached,for example, to a mixture-receiving bag 52 and the other communicatingwith a connector 40 d attached to a saline bag 54 containing a standardsaline solution. The saline bag 54 may be hung by an IV bag hook 55 tosuspend the saline bag 54 above the peristaltic pump 50.

The connectors 40 a, 40 b may be vented or unvented spikes that may beused to connect to a vial as is generally understood in the art. Theconnector 40 a, 40 b may also be a cap 32 a, 32 b secured to the vial 28a, 28 b and providing a filtered vent 34 a, 34 b and/or siphon tube 36a, 36 b as part of the mixing tube set 38.

The connectors 40 c, 40 d may be vented or unvented bag spikes that maybe used to connect to an IV bag as is generally understood in the art.

Each of the components of the connectors 40 a, 40 b, 40 c, 40 d, the Tconnector 44 a and 44 b, the pliable pump tube 46, and the branch tubes39 interconnecting these components, may be an integrated unit, factorysealed together at the time of manufacture, and disposed of withoutdisassembly.

Each of branch tubes 39 a-39 d may pass through correspondingconstriction valves 56 a-56 d positioned along their length betweenassociated connectors 40 and T connectors 44. These constriction valves56 operate by squeezing the branch tubes 39 to closure when activatedthus providing a valve action that does not contact the material withinthe branch tubes 39.

The branch tube 39 c may also pass through a spectrometer 60, forexample, a Raman spectrometer that allows evaluation of the contents ofthe material flowing into bag 52. Such a spectrometer 60 is described,for example, in U.S. provisional application 62/280,999 entitledApparatus and Method for Delivery-Contemporaneous Medicine Verificationfiled Jan. 20, 2016, and hereby incorporated by reference. Otherelements including those providing for barcoding, visual inspection,drug signature generation, and reporting for a drug may also be employedwith the present invention. In this regard, the bag 52 may be placed ona scale 62 providing a weight of the bag as it fills and upon completionof filling.

Each of the pump 50 valves, 56 electromagnetic actuator 42, scale 62,and spectrometer 60 may communicate with a computerized controller 64,for example, providing one or more processors 66 communicating with astored program 68 that can execute a sequence as will be described. Thecontroller 64 may also include a wireless transceiver 70, for example,providing Bluetooth or Wi-Fi interconnection with a separate controlcomputer 75 such as a tablet computer, desktop computer, or the like.This wireless connection allows operator control of the compoundingsystem 10 without opening of the glovebox 12. The control of the valvescan also be automatically realized by a computer program for a specificmixing process that does not need user intervention.

In this respect, the controller 64 may communicate with a controlcomputer 75 to receive operator instructions and receive compoundinginformation to perform the drug mixing process. For example, the controlcomputer 75 may receive information related to the fluid flow throughthe mixing tube set 38 and the associated volume of fluid being pumped,as opposed to air, between the vials 28 a and 28 b and saline bag 54 andreceiver bag 52. Similarly, the controller 64 may report the results ofthose processes to the control computer 75 for accounting purposes, forexample, to track drug usage downstream with respect to delivery to apatient.

The controller 64 may also receive a door open signal indicating whenthe front door 16 is open or ajar and to send a signal to the controllerto alert the operator that the front door 16 is not airtight sealed in aclosed state and to prevent further operator control of the compoundingsystem 10 until the door 16 is properly closed.

Referring now to FIGS. 2 and 4, in an example compounding sequence, amixing tube set 38 may be attached to vials 28 a and 28 b and to salinebag 54 and receiver bag 52 with low risk of exposure to a user throughthe use of standard medical coupling technologies. This assembly maythen be installed within the enclosure 14 feeding the appropriate branchtubes 39 through their corresponding valves 56 and pliable pump tube 46being threaded into the peristaltic pump 50. A bar code reader 76 or thelike may be used to read labels on the vials 28 a 28 b and saline bag 54and receiver bag 52, for example, prompted by illuminated lamps next toeach of these items or occurring automatically by means ofself-contained RFID tags or bar code readers or the like, and may beincorporated into the stations where these elements are naturallysupported within the enclosure 14. Prior to this time, a bar code may beprinted by the computer 75 using printer 73 for placement on thereceiving bag 52 and the computer 75 may receive, for example, from acentral server, compounding instructions for a medicine for a particularpatient that will be used to control the process as described and whichwill be used as a checklist against which to compare the contents of thevials 28 and is a manifest to make the barcode that is printed on thereceiving bag 52.

Once the proper materials have been loaded, an operator command may beprovided and valves 56 d and 56 a may open while valves 56 c and 56 bare closed, and the pump 50 may be operated in a forward direction todeliver saline from bag 54 to vial 28 a as indicated by process block72.

Per process block 74, vial 28 a may then be shaken, for example,manually or by use of an actuator 42 or the like.

Per process block 80, valve 56 d may then be closed and valve 56 copened, and pump 50 may then be operated in reverse direction to drawliquid from vial 28 a to the receiver bag 52 while its compoundedmaterial is monitored by the spectrometer 60 and the scale 62.

Valves 56 c and 56 a may then be closed and valves 56 d and 56 b openedso that material can be pumped by the pump 50 from the saline bag 54 tothe vial 28 b per process block 82. At process block 84, vial 28 b maybe shaken and then at process block 86, valve 56 d closed and valve 56 copened to transfer material into the receiving bag 52.

Upon completion of this mixing process, a portion of the material in thereceiving bag 52 may be drawn backward through the spectrometer 60 intoone of the vials 28 to provide more complete mixing and to provide asignature of the final drug in receiving bag 52 (e.g., both weight andconstitution). This signature may be used to track drug usage and/ordisposal through the lifecycle of the drug in bag 52, for example, asdescribed in the above referenced U.S. patent application 62/280,999.Drug identification can also be completed by obtaining spectrumsignature from the fluid inside the bag by placing the spectrometer nearthe bag.

In another example of a compounding sequence transmitted to the controlcomputer 75 to display operator instructions to perform the drug mixingprocess, the operator instructions may prompt the user to install themixing tube set 38 within the enclosure 14 feeding the appropriatebranch tubes 39 through their corresponding valves 56 and the pliablepump tube 46 being threaded into the peristaltic pump 50.

An operator command may be provided and all valves 56 a, 56 b, 56 c, and56 d may then be closed. Once all valves are shut, the user may beprompted to hang the saline bag 54 on the IV bag hook 55 and place thereceiver bag 52 on the scale 62 and attach the connector 40 c of branchtube 39 c and connector 40 d of the branch tube 39 d to the receiver bag52 and saline bag 54, respectively. The vials 28 a, 28 b may beinstalled on drug ingredient mounts 26 a, 26 b and the door 16 of theenclosure 14 may be closed over the door opening to provide an airtightsealed.

The user may use flexible airtight gloves 24 extending within theenclosure 14 to connect connectors 40 a and 40 b of the mixing tube set38 to the vials 28 a, 28 b.

Once the proper materials have been loaded, an operator command may beprovided and valves 56 d and 56 a may open while valves 56 c and 56 bare closed, and to operate the pump 50 in a forward direction to deliversaline from bag 54 to the vial 28 a. A liquid sensor 45 or the likearranged immediately before or immediately after the pump 50 at alocation between the first T-connector 44 a and second T-connector 44 bmay detect the flow of fluid through the pliable pump tube 46. In thisrespect, the liquid sensor 45 may sense the amount of saline deliveredto the vial 28 a as opposed to air trapped within the mixing tube set38. The liquid sensor 45 may be a sensor as described in U.S. Pat. No.9,242,037 entitled “Flow sensor for medical pump” and filed Dec. 12,2013 and U.S. Pat. No. 9,327,072 entitled “Multifunction capacitivesensor for medical pump” filed Dec. 12, 2013, both of which are herebyincorporated by reference. The filtered vent 34 a of the vial 28 a mayallow air trapped within the mixing tube set 38 to escape from the vial28 a while saline is pumped into the vial 28 a. The liquid sensor 45allows the control computer 75 to determine the amount of liquid iswithin the mixing tube set 38 when valves 56 d and 56 a are open andvalves 56 c and 56 b are closed to monitor the volume of salinedelivered to the vial 28 a.

Once the desired volume of saline is transferred to the vial 28 a, thevial 28 a may then be shaken, for example, manually or by use of anactuator 42 or the like.

The valve 56 d may then be closed and valve 56 c opened, and pump 50 maythen be operated in reverse direction to draw liquid from vial 28 a tothe receiver bag 52. The liquid sensor 45 may detect the flow of fluidthrough the pliable pump tube 46. In this respect, the liquid sensor 45may sense the amount of liquid delivered to the receiver bag 52 asopposed to air trapped within the mixing tube set 38. The receiver bag52 may be vented to allow air trapped within the mixing tube set 38 toescape from the receiver bag 52 while the liquid is pumped into thereceiver bag 52. The liquid sensor 45 allows the control computer 75 todetermine the amount of liquid is within the mixing tube set 38 whenvalves 56 c and 56 a are open and valves 56 d and 56 b are closed tomonitor the volume of liquid delivered to the receiver bag 52.

Similar to the process described with respect to vial 28 a, the processmay be repeated whereby valves 56 c and 56 a may then be closed andvalves 56 d and 56 b opened so that material can be pumped by the pump50 from the saline bag 54 to the vial 28 b. Vial 28 b may be shaken andvalve 56 d closed and valve 56 c opened to transfer material into thereceiving bag 52.

Upon completion of this mixing process, a clamp 53 or the like proximatethe neck of the receiving bag 52 may be closed for example, manually orby use of an automatic clamp controlled by the controller 64.

The operator instructions may prompt the user to open the door 16 anddisconnect the connector 40 c from the receiving bag. The receiving bag52 may be removed from the enclosure 14 for administration to thepatient.

The user may remove the mixing tube set 38 from the valves 56 and theperistaltic pump 50, remove the saline bag 54 from the IV bag hook 55,and remove vials 28 a, 28 b from the drug ingredient mounts 26 a, 26 b.The entire mixing tube set 38, saline bag 54 and vials 28 a, 28 b maythen be disposed of without disassembly.

It will be appreciated generally that the present invention provides acompact unit for compounding drugs that minimizes operator exposureallowing disposal of all drug-contacting materials.

Certain terminology is used herein for purposes of reference only, andthus is not intended to be limiting. For example, terms such as “upper”,“lower”, “above”, and “below” refer to directions in the drawings towhich reference is made. Terms such as “front”, “back”, “rear”, “bottom”and “side”, describe the orientation of portions of the component withina consistent but arbitrary frame of reference which is made clear byreference to the text and the associated drawings describing thecomponent under discussion. Such terminology may include the wordsspecifically mentioned above, derivatives thereof, and words of similarimport. Similarly, the terms “first”, “second” and other such numericalterms referring to structures do not imply a sequence or order unlessclearly indicated by the context.

When introducing elements or features of the present disclosure and theexemplary embodiments, the articles “a”, “an”, “the” and “said” areintended to mean that there are one or more of such elements orfeatures. The terms “comprising”, “including” and “having” are intendedto be inclusive and mean that there may be additional elements orfeatures other than those specifically noted. It is further to beunderstood that the method steps, processes, and operations describedherein are not to be construed as necessarily requiring theirperformance in the particular order discussed or illustrated, unlessspecifically identified as an order of performance. It is also to beunderstood that additional or alternative steps may be employed.

References to “a microprocessor” and “a processor” or “themicroprocessor” and “the processor,” can be understood to include one ormore microprocessors or other types of computers, gate arrays or thelike that can execute programs and communicate with each other.Furthermore, references to memory, unless otherwise specified, caninclude one or more processor-readable and accessible memory elementsand/or components that can be internal to the processor-controlleddevice, external to the processor-controlled device, and can be accessedvia a wired or wireless network.

It is specifically intended that the present invention not be limited tothe embodiments and illustrations contained herein and the claims shouldbe understood to include modified forms of those embodiments includingportions of the embodiments and combinations of elements of differentembodiments as come within the scope of the following claims. All of thepublications described herein, including patents and non-patentpublications, are hereby incorporated herein by reference in theirentireties.

We claim:
 1. A drug compounding system comprising: an outer housingproviding an internal cavity accessible through a door which may beopened and closed about the cavity; a peristaltic pump held within theinternal cavity; a first shut off valve; a second shut off valve; athird shut off valve; and a controller executing a stored program storedin memory to: communicate with the program, the peristaltic pump, thefirst shut off valve, the second shut off valve, and the third shut offvalve; and control operation of the peristaltic pump, the first shut offvalve, the second shut off valve, and the third shut off valve accordingto the program; wherein the first, second, and third shut off valves andthe peristaltic pump are configured to receive a mixing tube assemblyhaving a central tube section providing a compliant wall surrounding alumen for receipt of the central tube section by the peristaltic pumpfor pumping material through the central tube section by flexure of thewall of the central tube section and a branch connector communicatingwith a first end of the central tube section to provide conduits to afirst and second flexible branch tubes joining the lumen of the centraltube section to lumens of the first and second flexible branch tubes;and wherein the central tube fits within the first shut off valveconfigured to permit flow through the central tube in an open state andprevent flow through the central tube in a closed state, the firstflexible branch tube fits within the second shut off valve configured topermit flow through the first flexible branch tube in an open state andprevent flow through the first flexible branch tube in a closed state,and the second flexible branch fits within the third shut off valveconfigured to permit flow through the second flexible branch tube in anopen state and prevent flow through the first flexible branch tube in aclosed state; and further comprising a sensor held within the internalcavity and sensing fluid flow through the central tube section toanalyze a chemical composition of a material flowing through the centraltube section to establish a drug signature.
 2. The drug compoundingsystem of claim 1 wherein the door provides an airtight seal of theinternal cavity when in the closed state.
 3. The drug compounding systemof claim 1 further comprising a port in the outer housing for connectionto a fume extraction system.
 4. The drug compounding system of claim 1wherein the outer housing attaches flexible gloves extending within theinternal cavity and allowing an operator outside the outer housing tomanipulate elements within the internal cavity.
 5. The drug compoundingsystem of claim 1 wherein the door has a switch providing a door opencondition to the controller to prevent operation of the peristalticpump.
 6. The drug compounding system of claim 1 wherein the sensor is aRaman spectrometer.
 7. The drug compounding system of claim 1 whereinthe controller executes the stored program stored in memory to: open thefirst and second shut off valves to permit fluid flow through the firstflexible branch tube and central tube section and close the third shutoff valve to prevent fluid flow through the second flexible branch tube;pump fluid in a forward direction from the first flexible branch tube tothe central tube section; open the first and third shut off valves topermit fluid flow through the second flexible branch tube and centraltube section and close the second shut off valve to prevent fluid flowthrough the first flexible branch tube; and pump fluid in a reversedirection from the central tube section to the second flexible branchtube.
 8. The drug compounding system of claim 7 further comprising asensor wherein the computer executes the stored program stored in memoryto: detect a first amount of fluid pumped from the first flexible branchtube to the central tube section; and detect a second amount of fluidpumped from the central tube section to the second flexible branch tube.9. The drug compounding system of claim 1 wherein a second end of thecentral tube communicating with a first connector adapted for attachmentto a medicament vial, the first flexible branch tubes communicating witha second connector adapted for attachment to an IV bag, and the secondflexible branch tube communicating with a third connector adapted forattachment to a mixture receiving bag.
 10. The drug compounding systemof claim 9 further comprising a scale held within the internal cavityadapted to support the mixture receiving bag to provide a weight of themixture receiving bag.
 11. The drug compounding system of claim 9further comprising a hanger held within the internal cavity for hangingthe first IV bag positioned above the peristaltic pump.
 12. The drugcompounding system of claim 9 further comprising a mixer held within theinternal cavity and configured to shake the medicament vial.
 13. Thedrug compounding system of claim 9 wherein the IV bag contains a mixingfluid and the medicament vial contains a dissolvable drug ingredient.14. The drug compounding system of claim 1 further comprising a mixingtube assembly having a central tube section providing a compliant wallsurrounding a lumen for receipt of the central tube section by aperistaltic pump for pumping material through the central tube sectionby flexure of the wall of the central tube section; a branch connectorcommunicating with a first end of the central tube section to provideconduits to a first and second flexible branch tubes joining the lumenof the central tube section to lumens of the first and second flexiblebranch tubes; IV bag spikes attached to ends of the first and secondflexible branch tubes adapted for attachment to a first and second IVbags to communicate between volumes of the first and second IV bags andlumens of the first and second flexible branch tubes; and a medicamentcap connector communicating with a second end of the central tubesection and adapted to be releasably attached to a medicament containerto communicate between a volume of the medicament container and thelumen of the central tube section.
 15. The drug compounding system ofclaim 14 wherein the medicament cap connector has a filtered ventpermitting air to exit the medicament vial when the medicament capconnector is attached to the medicament vial.
 16. The drug compoundingsystem of claim 14 wherein the medicament cap connector has a siphontube extending into the medicament vial when the first connector isattached to the medicament vial.
 17. The drug compounding system ofclaim 14 wherein the medicament cap connector is a spike adapted forattachment to the medicament container.
 18. The drug compounding systemof claim 14 wherein the central tube section is a silicone rubbertubing.
 19. The drug compounding system of claim 14 wherein the branchconnector is a T-connector providing fluid communication between thefirst end of the central tube section and the first and second flexiblebranch tubes.